# 5 C.F.R. § 890.906 (2026): Retired enrolled individuals coinsurance payments

> Federal · Regulations · In force

URL: https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_906

## Section

- **Citation:** 5 C.F.R. § 890.906 (2026)
- **Heading:** Retired enrolled individuals coinsurance payments
- **Jurisdiction:** Federal
- **Kind:** Regulations
- **Status:** In force
- **Text as of:** August 14, 2026
- **Source:** Compiled text
- **Location:** Title 5 CFR: Administrative Personnel / Chapter I: OFFICE OF PERSONNEL MANAGEMENT / Part 890: FEDERAL EMPLOYEES HEALTH BENEFITS PROGRAM / Subpart I: Limit on Inpatient Hospital Charges, Physician Charges, and FEHB Benefit Payments / § 890.906: § 890.906   Retired enrolled individuals coinsurance payments.

## Text

(a) A retired enrolled individual's coinsurance responsibility for inpatient hospital services is calculated in accordance with the plan's contractual benefit structure and is based on the amount determined to be equivalent to the Medicare part A payment under the DRG-based PPS.
(b) A retired enrolled individual's coinsurance responsibility for physician services is calculated in accordance with the plan's contractual benefit structure and is based on the lower of the actual charges or the amount determined to be equivalent to the Medicare part B payment under the Medicare Participating Physician Fee Schedule for Medicare participating physicians and the Medicare Nonparticipating Physician Fee Schedule for Medicare nonparticipating physicians.
[60 FR 26668, May 18, 1995]

## Nearby sections

- [5 C.F.R. § 890.901 (2026) § 890.901   Purpose.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_901.md)
- [5 C.F.R. § 890.902 (2026) § 890.902   Definition.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_902.md)
- [5 C.F.R. § 890.903 (2026) § 890.903   Covered services.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_903.md)
- [5 C.F.R. § 890.904 (2026) § 890.904   Determination of FEHB benefit payment.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_904.md)
- [5 C.F.R. § 890.905 (2026) § 890.905   Limits on inpatient hospital and physician charges.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_905.md)
- [5 C.F.R. § 890.906 (2026) § 890.906   Retired enrolled individuals coinsurance payments.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_906.md)
- [5 C.F.R. § 890.907 (2026) § 890.907   Effective dates.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_907.md)
- [5 C.F.R. § 890.908 (2026) § 890.908   Notification of HHS.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_908.md)
- [5 C.F.R. § 890.909 (2026) § 890.909   End-of-year settlements.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_909.md)
- [5 C.F.R. § 890.910 (2026) § 890.910   Provider information.](https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_910.md)

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Source: Frix Law Library, https://www.frixlaw.com/law-library/statutes/CFR_T5_P890_S890_906. Check the current official text before relying on it. Not legal advice.